ABSTRACT
The treatment of acute illness in nursing homes is an ethical issue of great magnitude that has not been adequately explored despite the fact that about 20 percent of people over the age of 60 will spend some time in a nursing home. In nursing homes, decisions to treat or withhold diagnostic and therapeutic intervention occur daily in an environment that is not conducive to careful decision-making. Several documents have focused on issues such as the importance of identifying a surrogate, the substantive principles of surrogate decision-making, and the qualities of a surrogate decision-maker. In many cases, nursing care constitutes the main and often the only reason patients are residing in nursing homes. Professionals ought to ask relatives who are visiting the patient if there are others who should be consulted; if so, it is important to listen to the concerns of other family members.
